<?
//prep data for enroll again if enrolled again is enabled
if(isset($enrollagain))
{
	$enrollagain = (object)$enrollagain;

	$present_address = isset($enrollagain->present_address) ? $enrollagain->present_address : '';
	$contact_no = isset($enrollagain->contact_no) ? $enrollagain->contact_no : '';
	// $mobile_no = isset($enrollagain->mobile_num) ? $enrollagain->mobile_num: '';
	$email = isset($enrollagain->email) ? $enrollagain->email : '';
	$how_long_living_present_address = isset($enrollagain->how_long_living_present_address) ? $enrollagain->how_long_living_present_address : '';
	$last_school_name = isset($enrollagain->last_school_name) ? $enrollagain->last_school_name : '';
	$last_school_level = isset($enrollagain->last_school_level) ? $enrollagain->last_school_level : '';
	$last_school_address = isset($enrollagain->last_school_address) ? $enrollagain->last_school_address : '';
	$fathername = isset($enrollagain->fathername) ? $enrollagain->fathername : '';
	$father_age = isset($enrollagain->father_age) ? $enrollagain->father_age : '';
	$father_religion = isset($enrollagain->father_religion) ? $enrollagain->father_religion : '';
	$father_nationality = isset($enrollagain->father_nationality) ? $enrollagain->father_nationality : '';
	$father_educ_attain = isset($enrollagain->father_educ_attain) ? $enrollagain->father_educ_attain : '';
	$father_hobby_talent = isset($enrollagain->father_hobby_talent) ? $enrollagain->father_hobby_talent : '';
	$father_occupation = isset($enrollagain->father_occupation) ? $enrollagain->father_occupation : '';
	$father_office_add = isset($enrollagain->father_office_add) ? $enrollagain->father_office_add : '';
	$father_office_num = isset($enrollagain->father_office_num) ? $enrollagain->father_office_num : '';
	$mothername = isset($enrollagain->mothername) ? $enrollagain->mothername : '';
	$mother_age = isset($enrollagain->mother_age) ? $enrollagain->mother_age : '';
	$mother_religion = isset($enrollagain->mother_religion) ? $enrollagain->mother_religion : '';
	$mother_nationality = isset($enrollagain->mother_nationality) ? $enrollagain->mother_nationality : '';
	$mother_educ_attain = isset($enrollagain->mother_educ_attain) ? $enrollagain->mother_educ_attain : '';
	$mother_hobby_talent = isset($enrollagain->mother_hobby_talent) ? $enrollagain->mother_hobby_talent : '';
	$mother_occupation = isset($enrollagain->mother_occupation) ? $enrollagain->mother_occupation : '';
	$mother_office_add = isset($enrollagain->mother_office_add) ? $enrollagain->mother_office_add : '';
	$mother_office_num = isset($enrollagain->mother_office_num) ? $enrollagain->mother_office_num : '';
	$guardian_name = isset($enrollagain->guardian_name) ? $enrollagain->guardian_name : '';
	$relationship = isset($enrollagain->relationship) ? $enrollagain->relationship : '';
	$guardian_address = isset($enrollagain->guardian_address) ? $enrollagain->guardian_address : '';
	$guardian_contact_no = isset($enrollagain->guardian_contact_no) ? $enrollagain->guardian_contact_no : '';
	$guardian_reason = isset($enrollagain->guardian_reason) ? $enrollagain->guardian_reason : '';
	$parent_status = isset($enrollagain->parent_status) ? $enrollagain->parent_status : '';
	$parent_status_how_long = isset($enrollagain->parent_status_how_long) ? $enrollagain->parent_status_how_long : '';
	$parent_rights = isset($enrollagain->parent_rights) ? $enrollagain->parent_rights : '';
	$parents_rights_who = isset($enrollagain->parents_rights_who) ? $enrollagain->parents_rights_who : '';
}
$previous = [
'' => '--Select --',
'Nursery' =>'Nursery',
'Preparatory' => 'Preparatory',
'Kinder' => 'Kinder',
'Grade 1' => 'Grade 1',
'Grade 2' => 'Grade 2',
'Grade 3' => 'Grade 3',
'Grade 4' => 'Grade 4',
'Grade 5' =>'Grade 5',
'Grade 6' => 'Grade 6',
'Grade 7' => 'Grade 7',
'Grade 8' => 'Grade 8',
'Grade 9' => 'Grade 9',
'Grade 10' =>'Grade 10',
'Grade 11' => 'Grade 11',
'Grade 12' =>'Grade 12',
'4th Year' => '4th Year',
'3rd Year' => '3rd Year'
];

$year = range(1990,date('Y')-2);
$year_d[''] = 'Year';
foreach($year as $k => $v)
{
	$year_d[$v] = $v;
}
$month = array('jan','feb','mar','apr','may','jun','jul','aug','sep','oct','nov','dec');
$count = 1;
$month_d[''] = 'Month';
foreach($month as $v)
{
	$month_d[$count++] = ucwords($v);
}
?>


<?php
$genderAttrib = array('' => 'Select Gender...', 'male' => 'Male', 'female' => 'Female' );
$child_birth_position = array(''=>'-- Select --','first'=>'First','Second'=>'Second','third'=>'Third','fourth'=>'Fourth','fifth'=>'Fifth','sixth'=>'Sixth','youngest'=>'youngest','only'=>'Only');
?>
<div class="large-12 columns enrollment-menu content-views">
<?=$system_message;?>
<div class="alert-box">Enrollment Form</div>
<?echo form_open('register','id="check-form-submit" class="custom" data-abide autocomplete="off"');?>
<?$this->load->view('enrollment/notice')?>
<!-- start student personal info -->
	<div class="alert-box secondary" style="margin:0 auto;">Student Personal Information</div>
	<hr style="border:1px solid #2BA6CB;">
	<div class="row">
		<div class="large-4 columns">
			<label>Valid Email Address<span>&#10033;</span></label>
			<?='<br>'.form_error('email');?>
			<input type="email" data-tooltip other="Email Address" class="has-tip tip-top" title="E-Mail Address Student Information,Credentials and Other News will be sent on your email" name="email" placeholder="johndoe@email.com" value="<?=set_value('email',@$email);?>" required>
			<small class="error">Email is required and must be a valid email.</small>
		</div>
	</div>
	<div class="clearfix"></div>
	<div class="row">
		<div class="large-4 columns">
			<label>First Name<span>&#10033;</span></label>
			<?='<br>'.form_error('child_fname');?>
			<input type="text" name="child_fname" other="childs First name" value="<?=set_value('child_fname');?>" required>
			<small class="error">Firstname is required.</small>
		</div>
		<div class="large-4 columns">
			<label>Middle Name<span>&#10033;</span></label>
			<?='<br>'.form_error('child_mname') == ''?'<span style="font-size:10px;font-weight:bold;">If No middle name just put "none"</span>':'<br>'.form_error('child_mname');?>
			<input type="text" name="child_mname" other="Child's Middle name" id="Middlename" value="<?=set_value('child_mname');?>" required>
			<small class="error">Middle name is required.</small>
		</div>
		<div class="large-4 columns">
			<label>Last Name<span>&#10033;</span></label>
			<?='<br>'.form_error('child_lname');?>
			<input type="text" name="child_lname" other="Child's Last Name" value="<?=set_value('child_lname');?>" required>
			<small class="error">Middle name is required.</small>
		</div>
	</div>
	<div class="row">
		<div class="large-4 columns">
			<label>Nickname</label>
			<?='<br>'.form_error('child_nickname');?>
			<input type="text" name="child_nickname" other="child's Nickname/Preffered Name" value="<?=set_value('child_nickname');?>">
		</div>
		<div class="large-4 columns">
			<label>Name Ext (e.g jr,II,III)</label>
			<?='<br>'.form_error('child_name_ext');?>
			<input type="text" name="child_name_ext" other="Name Ext" value="<?=set_value('child_name_ext');?>">
		</div>
		<div class="large-4 columns">
			<label>Place of Birth<span>&#10033;</span></label>
			<?='<br>'.form_error('child_placeofbirth');?>
			<input type="text" name="child_placeofbirth" other="Place of Birth" value="<?=set_value('child_placeofbirth');?>" required>
			<small class="error">Place of Birth is required.</small>
		</div>
	</div>
	<div  class="row">
		<div class="large-6 columns">
			<label>Childs Birthdate:<span>&#10033;</span></label>
			<!--<<?='<br>'.form_error('child_bdate');?>
			<input type="text" name="child_bdate" placeholder="MM/DD/YYYY" other="birthdate" class="birthdate" value="<?=set_value('child_bdate');?>" pattern="month_day_year" required>
			<small class="error">Birthdate is required. and format must be MM/DD/YYYY</small>-->
			<?='<br>'.form_error('b_day');?>
			<div class="row">
				<div class="large-4 small-4 columns">
					<?=form_dropdown('b_month',$month_d,set_value('b_month'),'required');?>
					<small class="error">Month is required</small>
				</div>
				<div class="large-4 small-4  columns">
					<input type="text" name="b_day" value="<?=set_value('b_day');?>" placeholder="Day" pattern=[0-9] required>
					<small class="error">Day us required and must be numeric</small>
				</div>
				<div class="large-4  small-4  columns">
					<?=form_dropdown('b_year',$year_d,set_value('b_year'),'required');?>
					<small class="error">Year is required</small>
				</div>
			</div>
		</div>
		<div class="large-3 columns">
			<label>Gender<span>&#10033;</span></label>
			<?='<br>'.form_error('gender');?>
			<?=form_dropdown('gender', $genderAttrib, set_value('gender'),'other="Gender" required');?>
			<small class="error">Gender is required.</small>
		</div>
		<div class="large-3 columns">
			<label>Religious Affiliation<span>&#10033;</span></label>
			<?='<br>'.form_error('child_religous');?>
			<input type="text" name="child_religous" other="Religous Affilation" value="<?=set_value('child_religous');?>" required>
			<small class="error">Religous Affilation is required.</small>
		</div>
	</div>
	<span class="clearfix"></span>
	<div class="alert-box secondary" style="margin:15px 0;">Nationality Information</div>
	<div>
		<div>
			<?=form_error('child_nationality');?>
		</div>
		<div class="clearfix"></div>
		<div class="large-4 columns">
			
			<label>Nationality<span>&#10033;</span></label>
			<input type="text" id="nationality" name="child_nationality" other="nationality"  value="<?=set_value('child_nationality','filipino');?>" required>
			<small class="error">Nationality is required.</small>
		</div>
		
		<div class="clearfix"></div>
		<div id="for-foreign-students" class="hidden">
			<hr class="clearfix" style="border:2px solid #2BA6CB;">
			<div class="alert-box secondary" style="margin:0 auto;">For Foreign Students ONLY</div>
			<br class="clearfix">
			<div  class="row">
				<div class="large-4 columns">
					<label>SSP Number<span>&#10033;</span></label>
					<?='<br>'.form_error('nationality_ssp_number');?>
					<input type="text" name="nationality_ssp_number" class="nationality_must" other="SSP Number (if foreign only)" value="<?=set_value('nationality_ssp_number');?>">
					<small class="error">SSP Number is required.</small>
				</div>
				<div class="large-4 columns">
					<label>VISA Status<span>&#10033;</span></label>
					<?='<br>'.form_error('nationality_visa_status');?>
					<input type="text" name="nationality_visa_status" class="nationality_must" other="Visa Status(if foreign only)"value="<?=set_value('nationality_visa_status');?>">
					<small class="error">VISA Status is required.</small>
				</div>
				<div class="large-4 columns">
					<label>Authorized Stay<span>&#10033;</span></label>
					<?='<br>'.form_error('nationality_auth_stay');?>
					<input type="text" name="nationality_auth_stay" class="nationality_must" other="Authorized stay (if foreign only)" value="<?=set_value('nationality_auth_stay');?>">
					<small class="error">Authorized stay is required.</small>
				</div>
			</div>
			<div  class="row">
				<div class="large-4 columns">
					<label>Passport No.<span>&#10033;</span></label>
					<?='<br>'.form_error('nationality_passport_no');?>
					<input type="text" name="nationality_passport_no" class="nationality_must" other="Passport number(if foreign only)" value="<?=set_value('nationality_passport_no');?>">
					<small class="error">Passport No. is required.</small>
				</div>
				<div class="large-4 columns">
					<label>I-Card No.<span>&#10033;</span></label>
					<?='<br>'.form_error('nationality_icard_no');?>
					<input type="text" name="nationality_icard_no" class="nationality_must" other="I-Card (if foreign only)" value="<?=set_value('nationality_icard_no');?>">
					<small class="error">I-card is required.</small>
				</div>
				<div class="large-4 columns">
					<label>Date of Issue<span>&#10033;</span></label>
					<?='<br>'.form_error('nationality_date_issued');?>
					<input type="text" name="nationality_date_issued" class="nationality_must" other="Date of Issue (if foreign only)" class="datepicker" value="<?=set_value('nationality_date_issued');?>">
					<small class="error">Date of issue is required and must be a valid date MM/DD/YYYY</small>
				</div>
			</div>
			<hr class="clearfix" style="border:2px solid #2BA6CB;">
		</div>
	</div>
	<div class="alert-box secondary">Current Address Information</div>
	<div class="row">
		<div  class="large-6 columns">
			<label>City Address<span>&#10033;</span></label>
			<?='<br>'.form_error('child_city_address');?>
			<input type="text" name="child_city_address" other="Current Address" value="<?=set_value('child_city_address',@$present_address);?>" required>
			<small class="error">City Address is required.</small>
		</div>
		<div class="large-6 columns">
			<label>How Long has Child Lived in This Address?<span>&#10033;</span></label>
			<?='<br>'.form_error('child_adresshowlong');?>
			<input type="text" name="child_adresshowlong" other="How long has child been living in this address" value="<?=set_value('child_adresshowlong',@$how_long_living_present_address);?>" required>
			<small class="error">How long child has been living in this address is required.</small>
		</div>
	</div>
	<div class="row">
		<div class="large-6 columns">
			<label>Telephone Number<span style='font-size:11px'> optional (i.e 0446926750)</span></label>
			<?='<br>'.form_error('child_telno');?>
			<input type="text" name="child_telno" other="Contact Number" value="<?=set_value('child_telno',@$contact_no);?>">
			<small class="error">Contact Number is required.</small>
		</div>
		<!-- <div class="large-6 columns">
			<label>Mobile Number<span>&nbsp;&#10033;</span><span style='font-size:11px;'> (i.e +6391234567)</span></label>
			<?//='<br>'.form_error('child_mobno');?>
			<input type="text" name="child_mobno"  value="<?//=set_value('child_mobno',@$mobile_no);?>" required>
			<small class="error">Contact Number is required.</small>
		</div> -->
	</div>
	<div class="alert-box secondary" style="margin:10px 0;">Information About the Father</div>
	<div>
		<div class="row">
			<div class="large-4 columns">
				<label>Father's Full Name<span>&#10033;</span></label>
				<?='<br>'.form_error('father_name');?>
				<input type="text" name="father_name" other="Father's Name" value="<?=set_value('father_name',@$fathername);?>" required>
				<small class="error">This field is required.</small>
			</div class="large-4 columns">
			<div class="large-4 columns">
				<label>Father's Age <span>&#10033;</span></label>
				<?='<br>'.form_error('father_age');?>
				<input type="text" name="father_age"other="Father's Age" maxlength="3" value="<?=set_value('father_age',@$father_age);?>" required pattern="[0-9]">
				<small class="error">This field is required and must be numeric.</small>
			</div>
			<div class="large-4 columns">
				<label>Father's Religous Affilation:<span>&#10033;</span></label>
				<?=form_error('father_relaffil');?>
				<input type="text" name="father_relaffil" other="Father's Religious Affilation" value="<?=set_value('father_relaffil',@$father_religion);?>" required>
				<small class="error">This field is required.</small>
			</div>
		</div>
		<div class="row">
			<div class="large-4 columns">
				<label>Father's Citizenship:<span>&#10033;</span></label>
				<?='<br>'.form_error('father_citizenship');?>
				<input type="text" name="father_citizenship" other="Fathers Citizenship" value="<?=set_value('father_citizenship',@$father_nationality);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Fathers's Educational Attainment</label>
				<?='<br>'.form_error('father_educ');?>
				<input type="text" name="father_educ" other="Father's Educational Attainment" value="<?=set_value('father_educ',@$father_educ_attain);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Father's Hobbies/Talent</label>
				<?='<br>'.form_error('father_talent');?>
				<input type="text" name="father_talent" other="Father's Hobbies/Talent" value="<?=set_value('father_talent',@$father_hobby_talent);?>">
			</div>
		</div>
		<div class="row">
			<div class="large-4 columns">
				<label>Father's Occupation/Position<span>&#10033;</span></label>
				<?='<br>'.form_error('father_occup');?>
				<input type="text" name="father_occup" other="Father's Occupation/Position" value="<?=set_value('father_occup',@$father_occupation);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Father's Office Address<span>&#10033;</span></label>
				<?='<br>'.form_error('father_office_address');?>
				<input type="text" name="father_office_address" other="Father's Office Address" value="<?=set_value('father_office_address',@$father_office_add);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Father's Office Telephone Number</label>
				<?='<br>'.form_error('father_office_tel');?>
				<input type="text" name="father_office_tel" other="Father's Office Contact Number" value="<?=set_value('father_office_tel',@$father_office_num);?>">
			</div>
		</div>
	</div>
	<div class="alert-box secondary" style="margin:10px 0;">Information about the Mother</div>
	<div >
		<div class="row">
			<div class="large-4 columns">
				<label>Mother's Full Name<span>&#10033;</span></label>
				<?='<br>'.form_error('mother_name');?>
				<input type="text" name="mother_name" other="Mother's Name" value="<?=set_value('mother_name',@$mothername);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Mother's Age<span>&#10033;</span></label>
				<?='<br>'.form_error('mother_age');?>
				<input type="text" name="mother_age" other="Mother Age" maxlength="3" value="<?=set_value('mother_age',@$mother_age);?>" required pattern="[0-9]">
				<small class="error">This field is required and must be numeric.</small>
			</div>
			<div class="large-4 columns">
				<label>Mother's Religious Affilation<span>&#10033;</span></label>
				<?=form_error('mother_relaffil');?>
				<input type="text" name="mother_relaffil" other="Mother's Religious Affilation" value="<?=set_value('mother_relaffil',@$mother_religion);?>" required>
				<small class="error">This field is required.</small>
			</div>
		</div>
		<div class="row">
			<div class="large-4 columns">
				<label>Mother's Citizenship<span>&#10033;</span></label>
				<?='<br>'.form_error('mother_citizenship');?>
				<input type="text" name="mother_citizenship" other="Mother's Citizenship" value="<?=set_value('mother_citizenship',@$mother_nationality);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Mother's Educational Attainment<span>&#10033;</span></label>
				<?='<br>'.form_error('mother_educ');?>
				<input type="text" name="mother_educ" other="Mother's Educational Attainment" value="<?=set_value('mother_educ',@$mother_educ_attain);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Mother's Hobbies/Talent</label>
				<?='<br>'.form_error('mother_talent');?>
				<input type="text" name="mother_talent" other="Mother's Hobbies/Talent" value="<?=set_value('mother_talent',@$mother_hobby_talent);?>">
			</div>
		</div>
		<div class="row">
			<div class="large-4 columns">
				<label>Mother's Occupation/Position<span>&#10033;</span></label>
				<?='<br>'.form_error('mother_occup');?>
				<input type="text" name="mother_occup" other="Mother's Occupation/Position" value="<?=set_value('mother_occup',@$mother_occupation);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Mother's Office Address<span>&#10033;</span></label>
				<?='<br>'.form_error('mother_office_address');?>
				<input type="text" name="mother_office_address" other="Mother's Office Address" value="<?=set_value('mother_office_address',@$mother_office_add);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Mother's Office Telephone Number</label>
				<?='<br>'.form_error('mother_office_tel');?>
				<input type="text" name="mother_office_tel" other="Mother's Office Telephone Number" value="<?=set_value('mother_office_tel',@$mother_office_num);?>">
			</div>
		</div>
	</div>
	
	<div >
		<div class="alert-box secondary" style="margin:10px 0;">Information about the guardian</div>
		<div class="row">
			<div class="large-4 columns">
				<label>Guardian's Full Name<span>&#10033;</span></label>
				<?='<br>'.form_error('guardian_name');?>
				<input type="text" name="guardian_name" other="Guardian's Full Name" value="<?=set_value('guardian_name',@$guardian_name);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Relation To Child<span>&#10033;</span></label>
				<?='<br>'.form_error('guardian_relation');?>
				<input type="text" name="guardian_relation"other="Guardian's Relation to child" value="<?=set_value('guardian_relation',@$relationship);?>" required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Guardian's Address<span>&#10033;</span></label>
				<?='<br>'.form_error('guardian_address');?>
				<input type="text" name="guardian_address" other="Guardian's Address" value="<?=set_value('guardian_address',@$guardian_address);?>" required>
				<small class="error">This field is required.</small>
			</div>
		</div>
		<div class="row">
			<div class="large-4 columns">
				<label>Guardian's Contact Number<span>&#10033;</span></label>
				<?='<br>'.form_error('guardian_contact_num');?>
				<input type="text" name="guardian_contact_num" other="Guardian's Contact Number" value="<?=set_value('guardian_contact_num',@$guardian_contact_no);?>"required>
				<small class="error">This field is required.</small>
			</div>
			<div class="large-4 columns">
				<label>Reason for Need of Guardian<span>&#10033;</span></label>
				<?='<br>'.form_error('guardian_reason');?>
				<input type="text" name="guardian_reason" other="Reason for Need of Guardian" value="<?=set_value('guardian_reason',@$guardian_reason);?>"required>
				<small class="error">This field is required.</small>
			</div>
		</div>
	</div>

<!-- 	<div class="alert-box secondary">Educational Background</div>

	<p class="title">Recent School Information</p>
	<div class="row">
		<div class="large-4 columns">
			<label class="radius secondary label">School Last Attended<span>&#10033;</span></label>
			<?//='<br>'.form_error('school_last_attended');?>
			<input type="text" name="school_last_attended" other="School last attended" value="<?//=set_value('school_last_attended',@$last_school_name);?>" required>
			<small class="error">This field is required.</small>
		</div>
		<div class="large-4 columns">
			<label class="radius secondary label">School Level Completed<span>&#10033;</span></label>
			<?//='<br>'.form_error('school_level_completed');?>
			<?//=form_dropdown('school_level_completed', $previous, @$last_school_level);?>
			<small class="error">This field is required.</small>
		</div>
		<div class="large-4 columns">
			<label class="radius secondary label">Address Of School<span>&#10033;</span></label>
			<?//='<br>'.form_error('school_address');?>
			<input type="text" name="school_address" other="School Address" value="<?//=set_value('school_address',@$last_school_address);?>" required>
			<small class="error">This field is required.</small>
		</div>
	</div>
	<p class="title">Pre-Elementary</p>
	<div class="row">
		<div class="large-4 columns">
			<label>Inclusive Years</label>
			<?//=form_error('pre_elem_years');?>
			<textarea name="pre_elem_years"><?//=set_value('pre_elem_years');?></textarea>
		</div>
		<div class="large-4 columns">
			<label>School</label>
			<?//=form_error('pre_elem_school');?>
			<textarea name="pre_elem_school"><?//=set_value('pre_elem_school');?></textarea>
		</div>
		<div class="large-4 columns">
			<label>Awards Received</label>
			<?//=form_error('pre_elem_awards');?>
			<textarea name="pre_elem_awards"><?//=set_value('pre_elem_awards');?></textarea>
		</div>
	</div>
	<p class="title">Elementary</p>
	<div class="row">
		<div class="large-4 columns">
			<label>Inclusive Years</label>
			<?//=form_error('elem_years');?>
			<textarea name="elem_years"><?//=set_value('elem_years');?></textarea>
		</div>
		<div class="large-4 columns">
			<label>School</label>
			<?//=form_error('elem_school');?>
			<textarea name="elem_school"><?//=set_value('elem_school');?></textarea>
		</div>
		<div class="large-4 columns">
			<label>Awards Received</label>
			<?//=form_error('elem_awards');?>
			<textarea name="elem_awards"><?//=set_value('elem_awards');?></textarea>
		</div>
	</div>
	<p class="title">Highschool</p>
	<div class="row">
		<div class="large-4 columns">
			<label>Inclusive Years</label>
			<?//=form_error('hs_years');?>
			<textarea name="hs_years"><?//=set_value('hs_years');?></textarea>
		</div>
		<div class="large-4 columns">
			<label>School</label>
			<?//=form_error('hs_school');?>
			<textarea name="hs_school"><?//=set_value('hs_school');?></textarea>
		</div>
		<div class="large-4 columns">
			<label>Awards Received</label>
			<?//=form_error('hs_awards');?>
			<textarea name="hs_awards"><?//=set_value('hs_awards');?></textarea>
		</div>
	</div> -->

<hr class="clearfix">
<div class="form-values">
	<input type="hidden" name="sdf_loc" value="<?=$token;?>">
	<input type="submit" name="fillup_profile" id="submit_fillup_profile" value="Save and Finish Enrollment" class="btn btn-success">
	
</div>
<?php echo form_close(); ?>
</div>
<script src="<?=script_url('custom/');?>"></script>